© Sebastien Duijndam

26 & 24 %

Percentage of 15-24-year-olds (women and men) who know about HIV/AIDS prevention.


Birth rate among young women aged between 15 and 19.

41 %

Percentage of women aged between 15 and 49 who have experienced sexual, physical or emotional abuse since the age of 15.

Médecins du Monde’s emergency response includes a range of humanitarian assistance programmes. Find out more below about our work and missions in Madagascar.


The fragile health system and difficult living conditions in Madagascar, exacerbated by the spread of epidemics, prevent the population from benefiting from good quality healthcare.

As a result, humanitarian assistance is desperately needed in the country.


    The health indicators on the island of Madagascar are alarming, especially those relating to sexual and reproductive health (SRH):

    • maternal mortality rate of 426/100,000
    • 46% of births attended by qualified healthcare staff
    • 39% of births take place in a healthcare facility
    • 56.7% of mothers attend antenatal consultations
    • 38% use of modern contraception among young people aged between 15 and 19 who are sexually active.

    Madagascar stands out in Africa for its particularly restrictive abortion law and high level of resistance to any relaxation of the law. Nevertheless, abortions are regularly accessed illegally by many women, often leading to complications including haemorrhages, failure to expel the foetus, retention of the placenta, uterine rupture and infections.


    Complications of abortion are the second leading cause of maternal mortality in Madagascar (16% of maternal deaths).


    Madagascar has a fragile health system beset by recurring crises. Life expectancy at birth is just 65 for men and 68 for women.

    In the crisis-hit areas and especially in the south of the country, in Androy Region, the mortality rate for children under five is 74 per thousand and only 1% of the population has access to basic sanitation. Severe drought in this area in 2020 and 2021 led to widespread food insecurity and during the first three months of 2021 acute malnutrition affected 27% of the population.


    Madagascar has experienced diseases with epidemic potential for many years. These include plague and measles, with over 1,000 deaths from measles recorded in 2018 and 2019.

    The arrival of Covid-19 in 2020 was a further blow. The epicentre initially focused on the city of Toamasina, passing a few weeks later to the capital, Antananarivo, where it severely disrupted the city’s healthcare facilities and people’s access to healthcare. At the end of 2021, Madagascar had recorded around 64,000 cases of Covid-19 and over 1,500 deaths, but it should be noted that testing capacity was very poor throughout the pandemic.


Médecins du Monde’s work in Madagascar takes different forms, including improving sexual and reproductive healthcare provision, Opération Sourire and medical interventions to respond to the Covid-19 crisis.

Tackling the food crisis

Since 2020 Madagascar has been suffering its worst drought for 40 years which has plunged the country into a major food crisis. In addition, the lack of healthcare infrastructure means the population has no access to basic services to treat conditions such as diarrhoea, respiratory infections, fever and malaria. In 2021, Médecins du Monde organised two mobile clinics in the districts of Ambovombe and Amboasary, the regions which have been longest affected by drought.

Given the urgency of the situation and the need to provide integrated food and health support, we have had to expand our humanitarian activities and intend to organise two additional mobile clinics for the area in 2022.


    In 2021:

    • 1,737 children aged between 6 and 59 months were screened for malnutrition,
    • 316 children with severe acute malnutrition were treated at the mobile clinics,
    • 3,997 consultations were provided,
    • 15 emergency referrals to the regional hospital were made,
    • 6,522 people in the communities received information about GBV, human rights, positive masculinity and family planning.

Restoring smiles

Through Opération Sourire, children with maxillofacial lesions, scarring resulting from burns or congenital defects of the autonomic nervous system are operated on and monitored by MdM teams in Madagascar.

Surgery campaigns for both children and adults take place four or five times a year in Antananarivo and around the country. This type of medical intervention has changed the lives of many people in Madagascar.

Opération Sourire : l'histoire de Brice-Lane

Improving sexual and reproductive health

In 2017, Médecins du Monde France launched a sexual and reproductive health (SRH) programme. The aim of the programme is to help to reduce maternal mortality and morbidity associated with the lack of access to good SRH services, especially among 10-24-year-olds.

We work by strengthening the role of civil society and public institutions which are active in the field of sexual and reproductive health in Antananarivo.

The humanitarian programme aims to improve the prevention and management of unintended pregnancies.

It takes a rights-based approach and involves three main elements:

  • a community element in partnership with Malagasy NGOs (Tanora IRAI, Tanora GARANTEEN, Tandem, ASOS and Mira Aina), which aims to empower young people to take control of their own health,
  • a medical element, which aims to improve the accessibility and quality of SRH services tailored to meet the needs of young people at seven basic healthcare centres,
  • an advocacy element, which aims to promote young people’s right to choose in relation to SRH.
  • 57 044

    Beneficiaries in 2022.

  • 1,240,661

    Budget in 2022.

57 044

Beneficiaries in 2022.


Budget in 2022.

  • 1986
    Médecins du Monde’s first intervention in Madagascar.
  • 1993
    Programme to tackle STIs started in Antananarivo.
  • 1995
    Paediatric cardiac surgery programme started in Antananarivo.
  • 2004
    Launch of Opération Sourire in Madagascar.
  • 2005
    Programme to support detainees in prisons in Madagascar.
  • 2005
    Programme of abdominal surgery in Antananarivo.